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Change, Grow, Live in Coventry and Warwickshire Good

Inspection Summary


Overall summary & rating

Good

Updated 29 May 2019

We rated Change, Grow, Live in Coventry and Warwickshire as good because:

  • The service provided safe care. The premises where clients were seen were safe and clean. The number of clients on the caseload of the teams, and of individual members of staff, was not too high and staff ensured that people who required urgent care were seen promptly. Staff assessed and managed risk well and followed good practice with respect to safeguarding.

  • Staff developed holistic, recovery-oriented plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the clients and staff engaged in clinical audit to evaluate the quality of care they provided.
  • The teams included or had access to the full range of specialists required to meet the needs of the clients. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multi-disciplinary team and with relevant services outside the organisation.
  • Staff treated clients with compassion and kindness and understood the individual needs of patients. They actively involved clients and families and carers in care decisions.
  • The service was easy to access. Staff assessed and treated people who required urgent care promptly and those who did not require urgent care did not wait too long to start treatment. The service did not exclude people who would have benefitted from care.
  • The service was well led and the governance processes ensured that procedures relating to the work of the service ran smoothly.

However:

  • The hubs in Rugby and Nuneaton were new to the service and we found that not all rooms used for one to one support were adequately soundproofed. This was fed back to managers who have put music in the corridors and have an action plan to have further work completed to rectify this issue.
  • Staff understood the need for independent advocacy for clients and knew who to contact but this information was not displayed in public areas for clients to access it.
Inspection areas

Safe

Good

Updated 29 May 2019

We rated safe as good because:

  • All clinical premises where clients received care were safe, clean, well equipped, well furnished, well maintained and fit for purpose.

  • The service had enough staff, who knew the clients and received training to keep people safe from avoidable harm. The number of clients on the caseload of the teams, and of individual members of staff, was not too high.

  • Staff assessed and managed risks to clients and themselves. They developed recovery and risk management plans when this was necessary, and responded promptly to sudden deterioration in a patient’s health.

  • Staff understood how to protect clients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

  • Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date and easily available to all staff providing care.

  • The service managed client safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave clients honest information and suitable support.


Effective

Good

Updated 29 May 2019

We rated effective as good because:

  • Staff assessed the treatment needs of all patients. They developed individual care plans and updated them when needed. Care plans reflected the assessed needs, were personalised, goal focussed and recovery-oriented and staff updated them when appropriate.

  • Staff provided a range of care and treatment interventions suitable for the client group. They ensured that clients had good access to physical healthcare and supported clients to live healthier lives.

  • The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers made sure they had staff with a range of skills needed to provide high quality care. They supported staff with appraisals, supervision and opportunities to update and further develop their skill. Managers provided an induction programme for new staff.

  • Staff from different disciplines worked together as a team to benefit patients. They supported each other to make sure that clients had no gaps in their care. The team(s) had effective working relationships with other relevant teams within the organisation and with relevant services outside the organisation.

Caring

Good

Updated 29 May 2019

We rated caring as good because:

  • Staff treated clients with compassion and kindness. They understood the individual needs of clients and supported clients to understand and manage their care, treatment or condition.

  • Staff involved clients in care planning and risk assessment and actively sought their feedback on the quality of care provided.

  • Staff informed and involved families and carers appropriately.

However:

  • Staff understood the benefits of independent advocacy for clients but did not display information about these services in public areas of the hubs

Responsive

Good

Updated 29 May 2019

We rated responsive as good because:

  • The service was easy to access. Its referral criteria did not exclude people who would have benefitted from care. Staff assessed and treated people who required urgent care promptly and people who did not require urgent care did not wait too long to start treatment. Staff followed up people who missed appointments.

  • The teams met the needs of all people who use the service – including those with a protected characteristic. The hubs had easy access for those with disabilities, access to interpreters and information in easy read versions for clients

  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.

However:

  • Not all rooms in Nuneaton and Rugby were fully soundproofed and conversation could be heard in other rooms and the corridors. Managers were informed and an action plan was put in place to rectify this as soon as work could be completed

Well-led

Good

Updated 29 May 2019

We rated well-led as good because:

  • Leaders had the skills, knowledge and experience to perform their roles, had a good understanding of the services they managed and were visible in the service and approachable for clients and staff.

  • Staff knew and understood the provider’s vision and values and how they were applied in the work of their team.

  • Staff felt respected, supported and valued. They reported that the provider promoted equality and diversity in its day to day work and in providing opportunities for career progression. They felt able to raise concerns without fear of retribution.

  • Our findings from the other key questions demonstrated that governance processes operated effectively at team level and that performance and risk were managed well.

  • Teams had access to the information they needed to provide safe and effective care and used that information to good effect.

Checks on specific services

Substance misuse services

Good

Updated 29 May 2019

see detailed findings